Closed inter locking nail for the management of femur in adults

Abstract

Background and Aim: Casting often leads to malalignment, increased chances of non-union and also stiffness in the joints from prolonged immobilization. Hence the aim of the study was to see the effectiveness of interlocking intramedullary nailing of diaphyseal fracture of femur in adults.Material & Method: A total of 40 patients were included in the study. All the included patients had fracture of diaphysis of femur. Length of nail was selected by measuring the normal femur from tip of greater trochanter to knee joint line. Results were evaluated using modification of Klaus, W. Klemm et al criteria for the results of treatment.Results: A fair result meant loss of 30% of hip and knee motion, with more than 2 cm of quadriceps atrophy and angulation in any plane between 5 to 10. A poor result was with marked restriction of hip and knee motion and gross muscle atrophy and shortening and deformity greater than 10. Excellent result were obtained in 6 cases, good results were obtained in 24 cases and fair results in 10 cases.Discussion & Conclusion: Closed interlocking nails achieves strength of femoral diaphyseal fracture shaft in all three planes of loading- bending, compression and torsion. There is no significant change in the union rate when compared with age, sex and level of fracture. The rate of union compared to other modalities of treatment is excellent.